title: Rural native veterans in the Veterans Health Administration: characteristics and service utilization patterns.
abstract: OBJECTIVE
  The Department of Veterans Affairs (VA) and the Indian Health Service (IHS) signed a Memo of Understanding in 2010 to strengthen their partnership in improving health care services for Native veterans, who are disproportionately rural. This paper describes the demographic and service use profile of rural Native veterans who access VA health care.
  
  
  METHODS
  Data were abstracted from the 2008 Veteran Health Administration (VHA) medical dataset, and the characteristics of rural Native veterans were compared to rural non-Native veterans.
  
  
  RESULTS
  Rural Native veterans were more rural (41% vs 35%) and more highly rural (8% vs 2%) compared to non-Native veterans. Rural Native veterans were younger, more likely to be female, and earned about the same median income compared to rural non-Native veterans. Although rural Native veterans had fewer diagnoses on average, they were more likely to have served in combat areas and to have higher levels of service-connected disability compared to other rural veterans.
  
  
  CONCLUSIONS
  Demographic and service-related characteristics of rural Native veterans who accessed VA care differ from those of rural non-Native veterans. Identifying specific health care and service use characteristics will assist in the development of appropriate policy and programs to serve rural Native veterans.
authors.affiliation: Centers for American Indian and Alaskan Native Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045, USA. carol.kaufman@ucdenver.edu
authors.forename: Carol E
authors.initials: CE
authors.lastname: Kaufman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brooks
authors.forename: L Jeanne
authors.initials: LJ
authors.lastname: Kaufmann
authors.forename: Timothy
authors.initials: T
authors.lastname: Noe
authors.forename: Herbert T
authors.initials: HT
authors.lastname: Nagamoto
authors.forename: Nancy
authors.initials: N
authors.lastname: Dailey
authors.forename: Byron
authors.initials: B
authors.lastname: Bair
authors.forename: Jay
authors.initials: J
authors.lastname: Shore
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs; D016549:United States Indian Health Service / Q000706:statistics & numerical data*; D014728:Veterans / Q000706:statistics & numerical data*